A new study reported at Alzheimer's Association International Conference (AAIC) 2018 sought to investigate why results from the influential Women's Health Initiative-Memory Study (WHIMS) and WHI-Study of Cognitive Aging (WHISCA) differed from previous findings that suggest a worsening of cognition associated with hormone therapy.

Altogether, data suggest that menopausal hormone therapy is not associated with cognitive harm when therapy is initiated proximal to the menopausal transition when women are healthy (e.g., non-diabetic). The long-term effects of menopausal hormone therapy are yet unknown.

Carey E. Gleason, PhD, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, and researchers from Hartford Hospital, Hartford and George Washington University, D.C., looked at two separate studies published since WHIMS and WHISCA: the Kronos Early Estrogen Prevention Study-Cognitive and Affective Study (KEEPS-Cogs); and the Early v. Late Intervention Trial with Estradiol-Cognitive Endpoints (ELITE-Cog). The results showed:

• No negative effect on cognition was measured in women who had initiated hormone therapy between ages 50-54. In contrast, those who initiated hormone therapy between ages 65-79 demonstrated reductions in global cognition, working memory and executive functioning.
• Women on hormone therapy with type 2 diabetes also showed a higher risk of cognitive impairment compared to non-diabetic women on hormone therapy and diabetic women who were administered placebo treatment, after controlling for age.

"These findings add to our understanding of the complex effects of hormones on the brain," said Gleason. "These data are sorely needed to guide women's healthcare during and after the menopausal transition and to help women make personalized and informed decisions regarding management of their menopausal symptoms and the prevention of future adverse health outcomes."

This study was funded by the U.S. National Institute on Aging.